Bone Health | Osteoporosis

Osteoporosis is a progressive bone disease that is characterized by a decrease in bone density and can affect anyone, but mostly women develop the disease.

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Osteoporosis (porous bones) is a progressive bone disease that is characterized by a decrease in bone density with an increased risk of fractures. Osteoporosis is defined by the World Health Organization (WHO) as a bone mineral density of 2.5 standard deviations or more below the mean peak bone mass (average of young, healthy adults) as measured by dual-energy X-ray absorptiometry. The most common form of osteoporosis occurs in women after menopause. Senile osteoporosis occurs after age 75 and is seen in both females and males at a ratio of two to one. Secondary osteoporosis occurs at any age and affects men and women equally. Chronic predisposing medical problems or prolonged use of medications such as glucocorticoids cause secondary osteoporosis. A number of medications can increase the risk of osteoporosis.


The main problem associated with osteoporosis is the risk for bone fractures. In the elderly, osteoporosis can be associated with chronic pain due to fractures and can lead to further disability and early mortality. Fractures of the wrist, spine, shoulder and hip are the most common. Vertebral compression fractures are associated with back pain and shooting pain due to nerve root compression. Rarely will spinal cord compression occur and be life-threatening. Multiple vertebral fractures can lead to a stooped posture, loss of height and chronic pain with resultant reduction in mobility. Fractures of the long bones, such as hip fracture, require prompt surgery.

Osteoporosis is a progressive condition that can affect anyone; however, some groups are more prone to developing the disease, for example:

  • Women – one in five women over age 50 will have osteoporosis, but only one in 20 men will develop the condition

  • White and Asian women

  • Those with family history of osteoporosis

  • Women who had an oophorectomy before menses stopped naturally 

  • Underweight people

  • Heavy alcohol users

  • Smokers

To help prevent bones from weakening and reduce the risk associated with osteoporosis, there are lifestyle choices that are recommended such as:

  • Eating a healthy diet – including calcium, protein and vitamin D through diet or supplements – helps keep bones strong

  • Reducing alcohol intake

  • Not smoking

  • Performing weight-bearing exercises 

  • Avoiding falls

The diagnosis of osteoporosis can be made using conventional radiography and by measuring the bone mineral density. A method such as dual-energy X-ray absorptiometry scans the hip and spine to determine bone density compared to people of the same gender and age. Since many medical conditions can cause 

osteoporosis, it is important to perform appropriate blood tests to rule out underlying problems such as metastatic cancer, multiple myeloma and Cushing’s disease.

Treatment for osteoporosis includes bisphosphonate medications to prevent progression of the disease including:

  • Alendronate

  • Risedronate

  • Ibandronate

  • Zoledronic acid

Hormone therapy to help increase bone density include:

  • Denosumab  

  • Raloxifene (women)

  • Testosterone (men)

People with very low bone density may be prescribed bone-building medications such as:

  • Teriparatide

  • Ambipolarities

  • Romosozumab

Medications combined with healthy lifestyle choices can work together to help maintain bone health for those with osteoporosis.

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